Prospective study on antibiotics misuse among infants with upper respiratory infections

Sayed, Manal; Tamim, Hani; Jamal, Diana; Mumtaz, Ghina R.; Melki, Imad; Yunis, Khalid

doi:10.1007/s00431-008-0815-x

Cited by 12 publications

(7 citation statements)

References 41 publications

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“…Recent research demonstrates antibiotic prescribing rates as high as 69% to 79% for acute infectious rhinitis, which may account for up to 60% of all antibiotic prescriptions written by providers, despite often a lack of benefit and increased risk of adverse effects, including resistance. [94][95][96][97][98][99][100][101][102][103][104][105] Symptoms distinguishing viral versus bacterial infectious rhinitis/rhinosinusitis are minimal and recent evidence suggests that separating viral from bacterial infections based on clinical presentation is often not possible. 99,[106][107][108] In addition, because viral-induced infectious rhinitis/rhinosinusitis can cause sinus computed tomography (CT) scan changes that mimic acute bacterial rhinosinusitis, a CT scan should be deferred unless complications are a concern.…”

Section: Infectious Rhinitismentioning

confidence: 99%

Rhinitis 2020: A practice parameter update

Parameters

Contributors

2020

Journal of Allergy and Clinical Immunology

229

189

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Section: Infectious Rhinitismentioning

confidence: 99%

Rhinitis 2020: A practice parameter update

Parameters

Contributors

2020

Journal of Allergy and Clinical Immunology

229

189

View full text Add to dashboard Cite

“…Chest physiotherapy and mist steam does not improve the severity of the disease, respiratory parameters, nor reduce length of hospital stay or oxygen requirements in hospitalized infants with acute bronchiolitis not on mechanical ventilation. [ 83 ] There is insufficient evidence to show any benefit from steam inhalation. [ 83 ]…”

Section: Managementmentioning

confidence: 99%

Bronchiolitis in children: The Saudi initiative of bronchiolitis diagnosis, management, and prevention (SIBRO)

et al. 2018

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Bronchiolitis is the leading cause of admissions in children less than two years of age. It has been recognized as highly debated for many decades. Despite the abundance of literature and the well-recognized importance of palivizumab in the high risk groups, and despite the existence of numerous, high-quality, recent guidelines on bronchiolitis, the number of admissions continues to increase. Only supportive therapy and few therapeutic interventions are evidence based and proved to be effective. Since Respiratory Syncytial Virus (RSV) is the major cause of bronchiolitis, we will focus on this virus mostly in high risk groups like the premature babies and children with chronic lung disease and cardiac abnormalities. Further, the prevention of RSV with palivizumab in the high risk groups is effective and well known since 1998; we will discuss the updated criteria for allocating infants to this treatment, as this medication is expensive and should be utilized in the best condition. Usually, diagnosis of bronchiolitis is not challenging, however there has been historically no universally accepted and validated scoring system to assess the severity of the condition. Severe RSV, especially in high risk children, is unique because it can cause serious respiratory sequelae. Currently there is no effective curative treatment for bronchiolitis. The utility of different therapeutic interventions is worth a discussion.

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“…Antimicrobials are the most widely prescribed drugs in children worldwide, both in hospital [1, 2] and community settings [3], especially at preschool age [4]. It has been estimated that 37–61% of hospitalized infants and children receive antibiotics [5–9] and almost half of antibiotic prescriptions in children are unnecessary [10–12]. Despite national and international efforts to promote appropriate antibiotic prescribing [13], Italy is one of the European countries with the highest rate of inappropriate antibiotic prescriptions (e.g.…”

Section: Introductionmentioning

confidence: 99%

Antibiotic prescriptions in acute otitis media and pharyngitis in Italian pediatric outpatients

et al. 2019

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Background Acute otitis media (AOM) and pharyngitis are very common infections in children and adolescents. Italy is one of the European countries with the highest rate of antibiotic prescriptions. The aim of this study is to describe first-line treatment approaches for AOM and pharyngitis in primary care settings in Italy over six years, including the prevalence of ‘wait and see’ for AOM, where prescription of antibiotics is delayed 48 h from presentation, and differences in prescribing for pharyngitis when diagnostic tests are used. Methods The study is a secondary data analysis using Pedianet, a database including data at outpatient level from children aged 0–14 in Italy. Prescriptions per antibiotic group, per age group and per calendar year were described as percentages. “Wait and see” approach rate was described for AOM and pharyngitis prescriptions were further grouped according to the diagnostic test performed and test results. Results We identified 120,338 children followed by 125 family pediatricians between January 2010 and December 2015 for a total of 923,780 person-years of follow-up. Among them 30,394 (mean age 44 months) had at least one AOM diagnosis ( n = 54,943) and 52,341 (mean age 5 years) had at least one pharyngitis diagnosis ( n = 126,098). 82.5% of AOM diagnoses were treated with an antibiotic within 48 h (mainly amoxicillin and amoxicillin/clavulanate) and the “wait and see” approach was adopted only in 17.5% of cases. The trend over time shows an increase in broad spectrum antibiotic prescriptions in the last year (2015). 79,620 (63%) cases of pharyngitis were treated and among GABHS pharyngitis confirmed by rapid test 56% were treated with amoxicillin. The ones not test confirmed were treated mainly with broad spectrum antibiotics. Conclusions Despite guidance to use the ‘wait and see’ approach in the age group analyzed, this strategy is not often used for AOM, as previously noted in other studies in hospital settings. Broad-spectrum antibiotic prescription was more frequent when pharyngitis was not confirmed by rapid test, in keeping with evidence from other studies that diagnostic uncertainty leads to overuse of antibiotics. Electronic supplementary material The online version of this article (10.1186/s13052-019-0696-9) contains supplementary material, which is available to authorized users.

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Prospective study on antibiotics misuse among infants with upper respiratory infections

Cited by 12 publications

References 41 publications

Rhinitis 2020: A practice parameter update

Rhinitis 2020: A practice parameter update

Bronchiolitis in children: The Saudi initiative of bronchiolitis diagnosis, management, and prevention (SIBRO)

Antibiotic prescriptions in acute otitis media and pharyngitis in Italian pediatric outpatients

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